Surgical instrument



Mar. 420, 1923.

s. A. vA-N osDf-:L SURGICAL INSTRUMENT Filed Dec. 6, 1920 n, www ,Nw QN rammed Mai. zo, 192s.

inane F F l Q E SAMUEL A..k VAN OSDEL, OF JOHNSON, NEBRASKA.

SURGICAL INSTRUMIEN T.

.Application filed December 6, 1920. Serial No. 428,538.

To all whom t may concern.'

Be it known that l, SAMUEL A. VAN Osman, a citizen of the United States, and a resident of Johnson, county of Nemaha, State of Nebraska, have invented certain new and useful Improvements in Surgical instruments, of which the following is a specification. u

rlhis invention relates to surgical instruments, and is shown and described herein as embodied in an instrument of special utility in removing tonsils or other parts of the throat comparatively diflicult` of access, it being understood that by slight changes in the details of construction such as thc size and shape of the parts, it may be adapt-v ed for other uses.

Unless tonsils are comparatively prominent, they cannot be completely removed by a flat instrument, because of the engagementof the instrument with the faucial pillars of the throat, and if a flat instrument is used it is necessary to force the tonsil into proper position between the cooperating edges of the instrument, with `consequent inconvenience to the patient and to the operator. lf the tonsils are embedded, it is frequently necessary to dissect them by hand, the operation being tedious and resulting in much pain and great. danger of severe hemorrhage. y

@ne of the objects of this invention is to provide a simple and eflicient instrument for completely removing such relatively inaccessible parts,which can be readily positioned upon the part to be removed. Another object of the invention is to provide an instrument of this type by which a powerful crushing action can be effected and sustained, t lessen the loss of blood, and the part be then severed by a distinct cutting action. A still further object is the provision of an instrument of this type which can be readily operated by either hand, which is of simple construction, and'canber'eadily disassembled and cleaned, and which can be adapted for various uses by replacing certain of the parts.

Still further objects of the invention and the features of novelty will be apparent from the following specification when taken in connection with the accompanying drawings, in which:

Fig. 1 is a side elevation of an instrument embodying my invention, a portion of ythe handle being broken away and certain of the parts being shown as moved slightly from normal position, to more clearly disclose the structure;

Fig. 2 is a :fragmentary plan View of the forward end of the structure shown in Fig. 1;

Fig. 8 is an enlarged transverse vertical section taken on line'S-S of Fig. 1, looking in the direction of the arrow;

Fig. l is a vertical transverse section talren on line l-t of Fig. 1, one the parts being removed; and,

Fig. is a fragmentary vertical longitudinal section taken on the line 5 5 of Fig.

The instrument shown in the drawings comprises a frame having a straight for wardly projecting portion 11, provided with side walls 12, so as to be4 of channel shape in cross section, and having a handle 13 which may, if desired, be integral with the channeled portion 11, but is shown as detachably secured thereto to provide for the replacement of certain ofthe operating parts by parts of the shape and size desired. The channeled portion 11 is formed with an extension 14, and the upper end of the handle is hollow, having a transverse wall at its forward edge and spaced lateral walls 16, between which the extension 14 lits. A thumbscrew 17 extends laterally through the walls 16 and the extension 14 to rigidly secure the parts together, the extension being held against the forward wall 15 of the handle and clamped between the side walls 16 thereof. The handle 13 is preferably formed with a guard or bow to form an opening in which the fingers may be inserted to facilitate handling of the instrument.

At its forward end, the channeled portion 11 carries a loop 18 which is rigid therewith and extends at an abrupt angle therefrom. A hemostat member is slidably carried by the frame, having a main portion 19, which is received between the side walls 12 of the frame, and a loop 20 which projects from the main portion 19 and is shaped to conform to the shape of the loop 18 of the frame. A cutting member is also slidably carried by the frame, having a main portion 21, received between the side walls 12 of the frame, and a loop 22 which projects from the main portion 21 and fits in the loop 20 of the hemostat member. In order that the hemostat member and cutting membermay be properly guided on the frame,

desired, conform in shape to that of the lugs 23, but the main portion 21 of thev cutting blade is herein shown as cut away at its sides adjacent its: forward end as shown at 25, and the lugs 24 are formed, as shown in F ig. 3, to overlie and both the main portion 19 of the hemostat member and the main portion 21 of the cutting member. Provision is thus made for guiding the hemostat member when the cutting member has been removed, it being understood that upon sliding the hemostat member out of the channeled portion 11, the cutting' blade will fall and can then be withdrawn from the end of the frame, and the hemostat member, when replaced, will be held down by the lugs 24.

An operating lever is pivoted for swinging movement toward and from the handle 13, on` a pin 27 which is mounted in the side walls 16 of the handle, the lever 26 having a bayonet slot 28 therein so it can be detachably engaged on the pin 27, and having a reduced extension 29, which extends through a slot 30, in the main portion 19 of the hemostat member and a similar slot 31, in the main portion of the cutting blade. lA spring 32 is detachably secured on the handle 13, a T-shaped projection being provided on the handle vand an elongated slot being formed in the spring 32, so that the spring may be placed in position on the projection and rotated to thefoperative position shown. The free end of the spring engages a shoulder 34 on the lever 26 to resili'ently hold the lever in pivotal relation on the pin 27 and swing away from the handle v13. The extension 29 of the lever 26 is thus normally' held in'engagement with the extension 14 of the channeled portion 11 of the frame, and is suiiiciently extended to hold the hemostat member and the cutting kmember in assen'xbled relation on the frame.'v

A lever 35 is formed with a bayonet slot so as to be detachably and pivotally supported on a pin 36, which is mounted in the side walls 16 of the handle 13, and is formed with a narrowed extension 37, which is engaged in a slot 38 in the main portion 21 of the cutting member, so that this meinber may be retracted by swinging the lever 35 toward the handle 13. A spring 39 is d'etachably carried by the lever 34, being mounted on aT-shaped projection 40 thereon in a manner similar to the mounting of the spring 32 on the handle 13, and the free end of the spring engages the pin 36 to yieldingly hold the lever 35 on the pin. As shown in Fig. 1, the main portion 21 of the cutting member may be formed with a transverse web 41, separating the slots 31 and 38 therein, for engagement by the forward edge of the extension 37, and a projection 42 may be formed on the pin 36 for engagement by the spring 39, so that the spring will yieldingly hold the extension 3T of the lever in the extreme forward position and, by reason of the engagement of such extension with the web 41, will also yieldingly hold the cutting blade in its eXtreme forward position.

The loops 18 and 2O of the frame and hemostat member, respectively, being of the same size and shape, their meeting edges form opposed abutments, and their outer surfaces are tapered away from such abut ments as shown in Figs. 1, 2, and 5. The inner surface of the loop 2O is similarly tapered to receive the loop 22 of the cutting member which conforms to such shape and is likewise tapered on its inner surface and is also beveled to form cutting edge 42, for shearing action with the inner edge of the abutment on the loop 18 of the frame. A portion of the inner surface of the loop 18 of the frame is of uniform contour to receive the loop 22 of the cutting member, but that portion thereof adjacent the rear edge of the loop may be formed with an inwardly inclined surface 43, as shown in TFig. 5, for a purpose which will presently appear.

ln use the instrument is supported on either hand with the fingers inserted in the opening` in the handle 13, the parts being in the position shown in Fig. 1, except that the loop 22 of the cutting member would be enclosed in the loop 20 of the hemostat member 'as shown in Figs. 2 and 5. The loops 13 and 20 may be engaged between the anterior and posterior faucial pillars of the throat on opposite sides of the tonsil, and upon being gently pressed toward the tonsil, they will, by reason of the engagement of their slanting outer surfaces with the vfaucial pillars, pass around and close back of the capsule of the tonsil, thetonsil being thus forced into position between the abutments on the loops. When the instrument has been properly positioned, the hemostat blade is retracted by gripping the lever 26 toward the handle 13, the loop- 20 being thus forced t `ward the Vloop 18 to exert a powerful crushing action of the .tissues between the abutments of theloops'.

This action will thoroughly macerate the compressed tissues and the. pressure is sustained for a suflicient length of time to cause the walls of the blood vessels to stick together, permit the formation of blood clots and otherwise increase the hemostatic action. After a suitable lapse of time the tony y l i tionof a frame coniprising a forwardly proy sil is severed by retracting the cutting blade by engagement of the thumb of the hand which holds the instrument `with the lever' 35, the sharpened edge 42 of thel cutting blade 'cooperating with the inner edge of the abutment of the loop 18 to shear the clamped tissues and, by reason of the formation of the inclined inner `surface 43 of the loop 18 and of the oppositely inclined innerI surface of the loop` 22 of the cutting member, `the severed part will be reta-ined, thus obviating any danger of its being swallowed by the patient. y

lt will be apparent that the size and shape of the loops 18 and 20, as well as of the loop 22 of` the cutting blade, will be determined by the conditions of the particular operation to be performed, and that parts having loops of various sizes and shapes may be readily assembled in operative position upon the handle 13. It will also be apparent that, if` the operations to be performed require, as for instance` for removing adenoids, substitute parts may be provided, having their relatively sliding parts, that is, the channeled portion 11. of the frame and the main portions 19 and 21 of the heinostat member and the cutting member, uniformly curved in the required direction, and that, when positioned on the handle 18, such parts can be operated by the levers 26 and in the manner described.

The instrument comprises few parts, and these are of simple construction and can be readily disassembled and cleaned.` It is capable of adaptation for a variety of operations, and enables the operator to completely remove embedded tonsils as effectively as if dissected out by hand, without the disadvantages entailed by that method.

While the structure and operation of one embodiment of the invention has been shown and described, it will be understood that the changes suggested herein, aswell as other changes in the details of construction, may be made without departing froml the spirit of the invention which is defined in the appended claims.

The invention having been thus described, what is claimed is: i

1. In a surgical instrument,`the combination of a frame having a loop portion extending angularly therefrom to form an abutment, a secondary cooperating member slidably carried by the frame, said member operate with the other of said loops, and means for operating` said secondary coop# erating member and said blade.

2..n a surgical instrument, the combinajecting portion `and a portion offset therefrom to forma curved abutment, a; secondary cooperating member having a por` tion slidably engaged` with the forwardly projecting portion of the frame and having thereon an offset portion movabler toward and from the curved abutment of the frame,

a blade carried by said frame and having a cutting edge conforming to the shape ofsaid abutment, and means for yoperating said secondary cooperating member and said blade.

3. In a surgical instrument, the combinaw tion of a frame, a hemostat member slidably carried by said frame, said frame and said for shearing action with the other holloiv. `Y`

end portion,` and `means for sliding said hemostat member and said cutting member relative to said frame. i

et. In a surgical instrument for amputation, the combination of a frame, a member slidably carried thereby, said frame and said member having hollow end portions formed with opposing abut-ments, means for moving said member relative to the frame to clamp the part to be severed between said abutments, a. blade having a cutting edge for severing said part while so held, and means for operating said blade.`

5. In a surgical instrument, the combination of a frame having a forwardly extending channeled portion and a loop portion extending at an angle from said channeled portion, a secondary cooperating member having a portion slidably received in the channeled portion of the frame and having a loop. portion conforming to the shape of the loop portion of the frame, a cutting member having a portion slidably received in the channeled portion of the frame and having a loop portion telescopically received in the loop portion of the secondary member and formed with a cutting edge arranged for shearing action with the loop portion of the frame, and means for independently recipro- I,

eating said secondary member and said cutting member relative to said frame.

6. In a surgical instrument, the combination of a frame, a liemostat member slidably carried by said frame, said frame and sai-d member having enlarged hollow end portions providing opposed abutments, a cutting member slidable relative to said frame and having a portionformed with a cutting edge for shearing action with one of said abutments, the outer surfaces of said hollow end portions being tapered away from the abutments thereon, and means for independently sliding said hemostatmember and said eut- 4ting member relative to said frame.

' forward end, a secondary Cooperating member slidably supported on the Vframe and having an abutment opposied to the aburinent oi' the frame, a outting blade, means for operating said cutting blade, a leverl movable toward. said handle for operating` said secondary member, said lever having a bayonet slot connection with said handle and having an extension engaged 'in slots in said secondary member and said lcutting,` member, and a spring Cooperating` with said lever and said handle to hold them in pivotal relation, whereby said secondary member and said cutting member are held in assembled relation on said ira-me.

9. In a surgical instrument for amputatation, the eombination of a frame and a hemostat member slidably carried thereby keach comprising a body portion and a portion extending upwardly therefrom to form opposed abutments spaced. from the'pbody portion, a cuttingv member slidably carried by the frame and having a portion fitting in one of said upwardly extending` portions and formed with a Cutting edge arranged for shearing action with the inner edne oi the abutment of other of said upwardly extending portions, the inner surfaces oi' said other upwardly extending portion and o' that portion of the Cutting` member on which the cutting edge is formed being narrowed to retain the amputated part after it is severed, and means for independently sliding said hemostat member and said outting` member on said frame.

in testimony whereof I aiiix my signature.

SAMUEL A. VAN USDEL. 

